Saturday, December 19, 2015

Questioning isn't anti science

It’s not anti-psychiatry to question to question diagnoses made subjectively and modeled on middle-class norms.
It’s not anti-psychiatry to point out that African-Americans presenting with similar symptoms to whites are more likely to be diagnosed with schizophrenia, which carries with it far greater stigma than major depression or bipolar disorder.
It’s not anti-psychiatry to suggest that poor people don’t just lack mental health resources, but also the language of mental health in general, therefore less likley to seek out those resources...

I wrote this on my Tumblr a few days ago after a long exile. There's been a change, particularly in leftist-activist circles from shaming those who seek mental health care, to shaming those who question it. That there's less stigma surrounding mental illness than there was a decade ago is a good thing, but the way we talk about mental illness, particularly when it intersects with poverty, needs nuance.

In The Noonday Demon, Andrew Solomon writes: "If you're way down on the social ladder, however, the signs [of depression] may be less immediately visible. For the miserable and oppressed poor, life has always been lousy and they've never felt great about it." It's simple and, to be frank, slightly patronizing, but at least depression among poor people gets a meaty chapter, and he touches on more than the lack of resources. This is usually where most people stop: just give them better health care, free insurance, etc. But that alone doesn't build trust in institutions, and when you've grown up with the idea that institutions work against you, all the free health care in the world isn't going to change that.